Instrument No. 26 of 2004
Revocation and Determination
of
Statement of Principles
concerning
HAEMORRHOIDS
for the purposes of the
Veterans’ Entitlements Act 1986
and
Military Rehabilitation and Compensation Act 2004
1. The Repatriation Medical Authority under subsections 196B(2) and (8) of the Veterans’ Entitlements Act 1986 (the VEA):
(a) revokes Instrument No. 13 of 2000; and
(b) determines in its place the following Statement of Principles.
Kind of injury, disease or death
2. (a) This Statement of Principles is about haemorrhoids and death from haemorrhoids.
(b) For the purposes of this Statement of Principles, “haemorrhoids” means symptomatic dilatation of the superior or inferior haemorrhoidal plexus. This definition does not include anorectal varices.
(c) Haemorrhoids attracts ICD-10-AM code I84, O22.4, O87.2.
(d) In the application of this Statement of Principles, the definition of “haemorrhoids” is that given at paragraph 2(b) above.
Basis for determining the factors
3. The Repatriation Medical Authority is of the view that there is sound medical-scientific evidence that indicates that haemorrhoids and death from haemorrhoids can be related to relevant service rendered by veterans, members of Peacekeeping Forces, or members of the Forces under the VEA, or members under the Military Rehabilitation and Compensation Act 2004 (the MRCA).
Factors that must be related to service
4. Subject to clause 6, at least one of the factors set out in clause 5 must be related to the relevant service rendered by the person.
Factors
5. The factor that must as a minimum exist before it can be said that a reasonable hypothesis has been raised connecting haemorrhoids or death from haemorrhoids with the circumstances of a person’s relevant service is:
(a) being pregnant within the two weeks before the clinical onset of haemorrhoids; or
(b) straining at stool due to constipation or diarrhoea within the two weeks before the clinical onset of haemorrhoids; or
(c) having a spinal cord injury at the time of the clinical onset of haemorrhoids; or
(d) having chronic urinary obstruction at the time of the clinical onset of haemorrhoids; or
(e) being pregnant within the two weeks before the clinical worsening of haemorrhoids; or
(f) straining at stool due to constipation or diarrhoea within the two weeks before the clinical worsening of haemorrhoids; or
(g) having a spinal cord injury at the time of the clinical worsening of haemorrhoids; or
(h) having chronic urinary obstruction at the time of the clinical worsening of haemorrhoids; or
(i) inability to obtain appropriate clinical management for haemorrhoids.
Factors that apply only to material contribution or aggravation
6. Paragraphs 5(e) to 5(i) apply only to material contribution to, or aggravation of, haemorrhoids where the person’s haemorrhoids was suffered or contracted before or during (but not arising out of) the person’s relevant service.
Inclusion of Statements of Principles
7. In this Statement of Principles if a relevant factor applies and that factor includes an injury or disease in respect of which there is a Statement of Principles then the factors in that last mentioned Statement of Principles apply in accordance with the terms of that Statement of Principles.
Other definitions
8. For the purposes of this Statement of Principles:
“chronic urinary obstruction” means longstanding obstruction to the outflow of urine from the bladder;
“death from haemorrhoids” in relation to a person includes death from a terminal event or condition that was contributed to by the person’s haemorrhoids;
“ICD-10-AM code” means a number assigned to a particular kind of injury or disease in The International Statistical Classification of Diseases and Related Health Problems, 10th revision, Australian Modification (ICD-10-AM), Fourth Edition, effective date of 1 July 2004, copyrighted by the National Centre for Classification in Health, Sydney, NSW, and having ISBN 1 86487 594 1;
“relevant service” means:
(a) operational service under the VEA; or
(b) peacekeeping service under the VEA; or
(c) hazardous service under the VEA; or
(d) warlike service under the MRCA; or
(e) non-warlike service under the MRCA;
“spinal cord injury” means an injury to the long tracts of the spinal cord resulting in permanent motor or sensory deficits below the level of the lesion;
“terminal event” means the proximate or ultimate cause of death and includes:
(a) pneumonia;
(b) respiratory failure;
(c) cardiac arrest;
(d) circulatory failure; or
(e) cessation of brain function.
Application
9. This Instrument applies to all matters to which section 120A of the VEA or section 338 of the MRCA applies.
Dated this seventh day of October 2004
The Common Seal of the )
Repatriation Medical Authority )
was affixed to this instrument )
in the presence of: )
KEN DONALD
CHAIRMAN